Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698941788945.pdf (Zambia)
MINISTERIAL STATEMENT ON THE COVID-19 AND THE ACQUISITION OF VACCINES FOR COVID-19 BY THE HON.

MINISTER OF HEALTH (DR CHANDA), MP Mr Speaker, may I start by thanking you for according me this opportunity to address this august House and the nation at large to give an update on the Coronavirus Disease 2019 (COVID-19) and the acquisition of vaccines for COVID-19 in the country.
Mr Speaker, Government under the able leadership of His Excellency Dr. Edgar Chagwa Lungu, President of the Republic of Zambia, is resolved to ensuring that Universal Health Coverage (UHC) is attained in which our people have access to quality health services without suffering financial hardships.

This will attain through health system strengthening with primary health care approach as the bedrock spanning promotive, preventive, curative, rehabilitative and palliative care services.
One of the key areas of focus is enhancing public health security as this enables us to prevent and mitigate the various emerging and re-emerging public health threats and emergencies in our country.

Government has prioritised public health security and through this House enacted the Zambia National Public Health Act No.
19 of 2020 whose objects include among others the protection of Zambians from public health threats and emergencies such as Polio, Measles, Cholera, Typhoid, Ebola and now COVID-19 to mention but a few.

Mr Speaker, the COVID- 19 pandemic has in no doubt devastated the social economic activities globally, regionally and in our country, Zambia.
Government under the leadership of His Excellency Dr Edgar Chagwa Lungu, President of the Republic of Zambia, continues to support evidence based high impact innervations to prevent and mitigate the disruptive and catastrophic effects of COVID-19.

Mr Speaker, the COVID-19 pandemic is continually changing its presentation and recently we have noted an escalation of cases with many countries in America, Europe and Asia and in some 1 African countries experiencing a third wave.
This is indeed a clear indication that the pandemic is still with us and the third wave is probable and even imminent in a country like Zambia.

The House may wish to note that Zambia experienced the first wave of the COVID- 19 pandemic between May and August 2020 and the second wave from December 2020 to date.

The epidemiology of COVID- 19 keeps evolving and we are just coming out of the second of the wave and remain threatened by third wave with the upcoming cold season.
Zambia has made significant progress in controlling the second wave with a pick of over 1,796 cases in January 2021, to an average of less than 200 in the last two weeks.

In this period of the second wave we recorded a significant 24 deaths on one of the days.

However, we also note a reduction to an average of one death daily in the last two weeks and zero deaths today.
We also note the significant reduction in the number of hospitalisations in the same period from over 500 to only seventy six (76) currently, with a number of our wards being closed off.

Mr Speaker, it is slightly over one year since we recorded the first two cases of COVID -19 in the country.

The disease has become complex and dynamic in its presentation and management.

Although we note a significant reduction in the number of cases, the severity of cases remains a concern.
An average 70 per cent of our patients who are in our health care facilities are on oxygen therapy with up to 15 per cent critically ill.

The number of admissions has reduced but we are still seeing critically ill patients requiring scaled clinical in management.

Mr Speaker, the global epidemiology indicates a continued rise in the number of cases and mortalities.
The highest burden of COVID-19 cases globally is from Asia which is accounting for 42 per cent with India recording a new record of over 115, 000 cases in the last 24hrs.

South America has contributed 25 per cent of the global cases and Europe is contributing 20 per cent in the same period.

North Africa and East Africa continue to contribute the highest proportion of cases in Africa.
A cumulative globally of 133,050,039 COVID -19 cases including 2,886,728 deaths and 107,300,824 recoveries have been reported globally in the last 24 hrs as of 8hrs 7th April this morning.

In Africa the cumulative number of cases is 4,324, 965 cases including 114,610 and deaths and 3,875,884 recoveries.

2 Today, Zambia has recorded 315 new cases out of 7,261 tests conducted Representing a 4 per cent positivity rate.
Of note is that the positivity rate has been consistently below 5 per cent the past two weeks which is indicative of reduced community transmission.

This has brought the cumulative number of confirmed cases recorded to date to 89,386.

New cases broken down by province are as follows; (i) Eastern 115; (ii) North-Western 92; (iii) Lusaka (iv) Copperbelt (v) Northern (vi) Luapula (vii) Central (viii) Muchinga 42; 21; 19; 10; 08; 05; (ix) Western 03; and (x) Southern 00.
The Southern Province had no positive cases out of the 570 persons tested within the last twenty- four hours.

3 Mr Speaker, I am delighted to report that we have not recorded any COVID-19 associated deaths in the last twenty-four hours.

The cumulative COVID-19 related deaths still stand at 1,224 plus classified as 683 COVID-19 deaths, 540 COVID-19 associated deaths.
Among those hospitalised or in home isolation for COVID-19 management, seventy-one have been discharged from six provinces as follows: (i) Lusaka (ii) Copperbelt (iii) Eastern (iv) Central 47; 11; 06; 04; (v) North-Western 02; and (vi) Southern 01.

Cumulatively recoveries now stand at 85,409.

Sir, we currently have 2,753 active cases, of whom, 2,677 or 97 per cent are under community management and seventy-six or 3 per cent are admitted to our COVID-19 Isolation Facilities.
Among those admitted, fifty-six or 74 per cent are on oxygen therapy and ten are in critical condition.

Mr Speaker, the Government continues to use a multi-sectoral approach to respond to the COVID-19 pandemic.

The COVID-19 National Multi-sectoral Contingency and Response Plan outlines the various strategies being employed for preventing and mitigating the pandemic.
As a living document, the plan is reviewed and revised regularly depending on current and prevailing evidence as well as the trajectory of the pandemic.

The Ministry of Health is now using a nine- 4 pronged approach to control and prevent the outbreak from spreading further.

This is after inclusion of the COVID-19 Vaccination Strategy.
The strategies include: (i) surveillance and case fining; (ii) case management; (iii) infection prevention and control; (iv) risk communication and community engagement; (v) laboratory diagnosis; (vi) logistics and supply chain management; (vii) appropriate, competent and adequate workforce; (viii) routine essential health services; and (ix) COVID-19 vaccination.
Mr Speaker, recently, globally, including on the African continent, countries have adopted vaccination as an additional strategy to preventing and controlling COVID-19.

The available scientific evidence shows overwhelmingly that vaccine deployment is key in bringing the pandemic under control.

Countries like Israel and the United Kingdom that have made huge progress in their vaccine roll out have already posted significant reduction in COVID-19 transmission, severe illness, hospitalisation and deaths.
Following wide technical consultations and recommendations made to the Government by the Ministry of Health and the Ministry of Finance on 24th March, 2021, Cabinet unanimously approved and adopted the COVID-19 Vaccination Programme as an additional pillar of our COVID-19 Response Strategy for Zambia.

5 The vaccines will be administered cautiously and in a phased up manner and in a pilot and voluntary basis.

So, in short there will be no mandatory vaccination.
Sir, while all eligible adults over the age of eighteen years qualify to be vaccinated, the prioritised groups to get the vaccines first will be as follows; healthcare workers, as these are essential in sustaining the COVID-19 response; the police, security, teachers, traditional leaders, clergy and Immigration Officers, as these are essential to maintaining core societal functions.
Others include marketers, traders, including bus and truck drivers involved in cross border business, in view of the environment they work in.

Those older than sixty-five years old including those with chronic illnesses will also be prioritised as they are at greatest risk of severe illness and death.

Mr Speaker, following Cabinet guidance, Zambia’s COVID-19 Vaccination Programme will be conducted under four pillars.
Pillar one, Zambia will access vaccines under the COVAX Mechanism which include Astra Zeneca and subsequently the Johnson and Johnson Vaccine for at least 20 per cent of the eligible population which is 3,676,791 adults of the 46 per cent, 8,438,118 eligible population aged about eighteen years.

The vaccines where scheduled to be in the country by April, 2021.
However, as I have said earlier, India which has been mandated to produce the vaccine under the COVAX through the Serum Institute of India facility is undergoing a heightened COVID-19 outbreak.

In this regard, the date of expectation of the vaccines under the COVAX Mechanism in the country has been moved to May, 2021 in collaboration with United Nations International Children's Emergency Fund (UNICEF) and the World Health Organisation (WHO).
Mr Speaker, pillar two, the Government will accept free donations of vaccines from donors and cooperating partners, that is, other Governments and cooperating partners willing to support Zambia’s vaccination programme which will be subjected to the certification and approval by the Ministry of Health through the Zambia Medicines and Regulatory Authority (ZAMRA) to ensure that only vaccines that are safe, efficacious and authorised are permitted on the Zambian market.
6 I should mention, Mr Speaker, that both Pillar One and Two are free.

The Government will not spend any money.

Pillar Three, Sir, the private sector will also be allowed to participate in the vaccination programme.

This will be done with the approval of the Ministry of Health through ZAMRA.
Pillar Four, the Government will further source COVID-19 vaccines through the basket of vaccines which include a number of them like Pfizer, Moderna, Johnson and Johnson, Sinovac and Sputinik and others, authorised by the WHO to cover the remaining eligible population.

Mr Speaker, the under certainty in some circles of the public surrounding the COVID-19 vaccines is well noted.
In this regard, the Ministry of Health and the Ministry of Information and Broadcasting, and other stakeholders will continue to engage various stakeholders and the community and provide key insights on the COVID-19 Vaccine Programme using various channels of communication and at various levels.

We are hopeful that with the vaccines deployment we can attain herd immunity which means protecting the majority of our people from getting infection and thus control the pandemic.
Sir, we have continued to follow up other global concerns and decisions on the different COVID- 19 vaccines facilities available.

A trending concern surrounds the vaccines Astra Zeneca which has been topical on global news.

There is an investigation to the fact that eighteen people out of the 20 million vaccinated with Astra Zeneca in the United Kingdom developed severe conditions due to the clotting of their blood.
The WHO and the European Medicines Agency have indicated that blood clotting events occur frequently amongst the global population with a condition known as Venous Thromboembolism being the third most common cardiovascular disease even before the COVID-19 occurrence and vaccinations with Astra Zeneca.

The WHO maintains that benefits of Astra Zeneca far outweigh any risks and recommend the continued use of the vaccine.
Coronavirus itself is actually known to be thrombolytic virus and causes clotting, and we have managed many clotting cases in our Intensive Care Units (ICUs) in Zambia even before we deploy vaccines.

7 Mr Speaker, the Government will ensure that there is compliance with all regulatory requirements for vaccine acquisition and use are followed.
Once identification of the candidate vaccine is done, the ZAMRA will use one of the existing collaborative registration pathways including WHO Prequalification, Stringent Regulatory Authorities or Zazibona Joint Assessment Procedure to expedite the regulatory approval of vaccines.

Further, Mr Speaker, ZAMRA will heighten its pharmacovigilance and surveillance activities to ensure adequate monitoring of the safety and efficacy of any vaccines.
In addition, an independent body of health experts that regularly advises the Government on all matters of vaccinations in the country, the Zambia Immunisation Technical Advisory Group (ZITAG) will have input in all the relevant processes.

His Excellency the President, has guided that COVID-19 Vaccination Programme must be administered in a transparent and accountable manner and Zambian people’s lives have to be secured to be safe and no harm through any fake vaccines will be allowed.
Sir, one of the major preliquisite of the COVAX Facility is that all participating countries are required to sign Indemnification and Liability Agreements with the manufacturers of the vaccines.

A separate indemnity agreement will have to be signed with each manufacturer from doses that are allocated.

The Ministry of Health has sort guidance from the Ministry of Justice on the matter and the Attorney-General and the processes have been concluded.
Mr Speaker, the vaccine alone will not be adequate to control the pandemic.

It is emphasised that we continue adhering to the prescribed public health measures coined in the five golden rules: (a) mask up correctly and consistently; (b) maintain physical distance; (c) wash your hands frequently with soap and water or use hand sanitizer; (d) avoid crowed places, if possible particularly super spreader events or stay at home; and (e) seek medical attention early if you are symptomatic.
8 Mr Speaker, we must maintain adherence to all the above facets of the public health guidance until such a time when the majority of the population has been vaccinated.

Mr Speaker, it is worrying that a number of patients present late to the health care facilities and a few others are leaving the hospital against medical advice and returning to the facilities shortly thereafter in even worse condition.

Regrettably, the outcome among such patients is poor with other being fatal.

Hon.
Hon.

Members of this august House we seek your intervention to continue urging the member of your communities to seek medical care early and once admitted to follow the guidance given by the health care works.

I further, urge all hon.

Members of this House to promote the COVID-19 vaccine programme so that we and indeed the Zambian people can be protected from the devastating effects of COVID- 19 especially during an election year like this one.
Mr Speaker, the Ministry of Health using a multi-sectoral approach at various levels continues to ensure that our learning institutions that are schools, Colleges and Universities and other congregate getting comply with public health guidelines, screening and testing all those eligible ongoing in line with the prescribed guidelines.
The House may wish to note that learning institutions that will fail to comply with the prescribed health guidelines will be recommended for closure until they meet the prescribed standards.

Mr Speaker, I wish to conclude by reiterating that the Government of the Republic of Zambia under the able Leadership of His Excellency the President, Mr Edgar Chagwa Lungu, remains committed to saving lives, livelihoods and the economy.
As I end my statement, allow me to thank His Excellency, Mr Edgar Chagwa Lungu, the President of the Republic of Zambia for his resilience and exceptional stewardship in enhancing the health security of our country.

I also wish to thank you Mr Speaker and the National Assembly Management for the commitment and objective impute to the COVID-19 response at Parliament Buildings.
9 Mr Speaker, lastly but not less importantly allow me to thank the multisectoral responses teams and supporting co-operating partners that have put in a lot of effort in the fight against COVID- 19.

COVID-19 cannot be fought by the Government alone we all have our rolls to play in the fight against COVID-19 and together we can defeat COVID-19.

Mr Speaker, I thank you.

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